Does My Child Really Need a Filling in a Baby Tooth?

If your child has a cavity in a baby tooth, it is natural to wonder: Why fill a tooth that is eventually going to fall out anyway?

Sometimes a baby tooth does need a filling or other treatment. In other situations, the dentist may recommend a different approach. The right decision depends on the tooth, the amount of decay, whether your child has symptoms, how soon the tooth is expected to fall out and your child’s overall cavity risk.

The important point is that baby teeth still have important jobs to do while they are in your child’s mouth.

Why Treat a Cavity If the Baby Tooth Will Fall Out?

Baby teeth help children chew and speak, and they help maintain space as permanent teeth develop and eventually erupt.

A cavity is tooth decay, and decay can progress while the baby tooth is still needed. If it becomes deeper, a child may develop sensitivity, pain or infection and may eventually need more extensive treatment.

That is why the question is not simply “Is this a baby tooth?” The better question is:

What is likely to happen to this tooth if we leave the decay untreated?

Does Every Cavity in a Baby Tooth Need a Filling?

No. Dental cavities do not all present at the same stage, and treatment should be individualized.

Depending on the situation, a dentist may consider preventive care, monitoring, approaches intended to slow or arrest decay, a restoration such as a filling, or other treatment.

The recommendation may depend on factors including:

This is why two children with what parents simply call “a cavity” may receive different recommendations.

What Can Happen If We Wait?

Some early areas of decay may be appropriate for preventive or non-restorative management and careful monitoring. But decay that continues progressing can destroy more tooth structure and eventually reach the pulp — the living tissue inside the tooth.

At that point, treatment may become more involved. Deep decay can lead to inflammation of the pulp, pain and, in some cases, infection.

So “waiting” should be a clinical decision with a plan for monitoring, not simply ignoring a cavity because the tooth is temporary.

What If My Child Isn’t Having Any Pain?

A child does not have to complain of a toothache for decay to be present.

That is one reason regular dental examinations are useful. The dentist may identify decay before it becomes painful and discuss whether preventive care, monitoring or treatment is appropriate.

If you are wondering what cavities can look or feel like, read
Does My Child Have a Cavity? Signs Parents Should Watch For.

If your child is already complaining that a tooth hurts, read
My Child Says Their Tooth Hurts — When Should I Call the Dentist?

What Should I Ask Before Agreeing to a Filling?

Parents should feel comfortable understanding why treatment is being recommended.

Ask your dentist:

• How deep is the cavity?
• Is the decay progressing?
• How long is this baby tooth expected to remain?
• What could happen if we monitor it instead?
• Are there reasonable alternatives to a filling in this situation?
• What treatment would you recommend and why?

A good treatment discussion should help you understand both why treatment is recommended and what the alternatives are.

What If My Child Is Afraid of Getting a Filling?

Fear can be an important part of the treatment conversation, but it does not change whether decay needs attention.

Tell the dental office before the appointment if your child is especially nervous or has had a difficult dental experience. The dentist can consider your child’s age, treatment needs and ability to participate comfortably when discussing the appropriate approach.

If the appointment is already scheduled and your child is worried, read
My Child Is Scared of the Dentist — What Should I Do Before the Appointment?

If you are still choosing a dental office, read
How Do I Find a Dentist Who Is Good With Nervous Kids?

Can We Prevent the Next Cavity?

Finding one cavity is also an opportunity to look at why your child developed decay and what may reduce the chance of additional cavities.

Your dentist may discuss brushing with fluoride toothpaste, diet and snacking habits, professional fluoride treatment, dental sealants and an appropriate examination and cleaning schedule based on your child’s individual cavity risk.

If your child seems to keep developing decay, read
Why Does My Child Keep Getting Cavities?

You may also want to read
Does My Child Need Fluoride Treatment?
and
Does My Child Need Dental Sealants?

Children’s Dental Care at Cedar Hills Dental Care

Cedar Hills Dental Care provides family dentistry for children and adults near Beaverton. Our practice has served the community since 1986 and has cared for more than 10,000 smiles.

Christine Chin, DMD brings more than 35 years of dental experience and is an Oregon Health & Science University-educated dentist. Our approach emphasizes comfortable, compassionate and non-judgmental dental care.

If your child has a cavity in a baby tooth, we can examine the tooth, explain what we see and discuss the appropriate treatment options with you.

Learn more about our
Dental Care for Children
and our growing collection of resources for parents.

Further Reading for Parents

If your child has a cavity or is at increased risk for tooth decay, these Cedar Hills Dental Care articles may also help:

• Does My Child Have a Cavity? Signs Parents Should Watch For
• Why Does My Child Keep Getting Cavities?
• Does My Child Need Fluoride Treatment?
• Does My Child Need Dental Sealants?
• My Child Says Their Tooth Hurts — When Should I Call the Dentist?